Cat-scratch disease (CSD) is a benign, self-limited zoonotic infection characterized by a primary skin or conjunctival lesion after cat scratches or contact with a cat and subsequent acute to subacute tender regional lymphadenopathy, as well as systemic symptoms that may be debilitating.
Cat-scratch disease is not a severe illness in people who are healthy. But it can be a problem in people with weak immune systems. People with weak immune systems include those who are receiving chemotherapy for cancer, those who have diabetes or those who have acquired immunodeficiency syndrome (AIDS).
Causes of Cat-Scratch Disease
B.henselae causes granulomatous inflammation in healthy individuals (CSD) and angiogenesis in immuncompromised persons.
Symptoms of Cat-Scratch Disease
- Bump (papule) or blister (pustule) at site of injury, usually the first sign.
- Swelling of the lymph nodes near where the skin was bitten or scratched.
- Body rash
- Flu-like symptoms including headache, lethargy, decreased appetite, fatigue, joint pain, or fever
Diagnosis
Suggested by regional lymphadenopathy developing over a 2- to 3-week period in an individual with cat contact and a primary lesion at the site of contact and confirmed by identification of B. henselae from tissue or serodiagnosis.
Treatment
Symptomatic in most cases.
Antimicrobial Therapy In comparison with bacillary angiomatosis, which is also caused by B. henselae, specific antimicrobial therapies have not proved effective in treatment of CSD. Ciprofloxacin, doxycycline, erythromycin may be effective.
Surgery Occasionally, surgical drainage of suppurative node is indicated.
Prevention
Avoiding contact with cats prevents the disease. Where this is not reasonable, good hand-washing after playing with a cat, avoiding scratches and bites, and avoiding cat saliva will lessen the risk of infection.
References